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Deadline for States on Health Insurance Exchanges Extended

For the second time in a week, the Obama administration said on Thursday that it was extending the deadline for states to decide whether they will establish and operate online markets where consumers can shop for health insurance under the new health care law.

Friday was the original deadline. Now, the White House says, states do not have to decide until the middle of next month.

The postponement came in response to a request from the Republican Governors Association and its chairman, Gov. Bob McDonnell of Virginia. Many Republicans had deferred action, hoping that Mitt Romney would oust President Obama and work with Congress to repeal the health care law.

In a letter to the Republican governors on Thursday night, Kathleen Sebelius, the secretary of health and human services, said they would have until Dec. 14 to decide whether they wanted to establish their own health insurance exchanges. The federal government will create an exchange in any state that is unable or unwilling to do so.

The White House had originally said that states must submit applications to the federal government by Friday if they wanted to run their own exchanges. On Nov. 9, the administration extended the deadline for applications to Dec. 14, but said governors still had to submit "letters of intent" by Friday.

Now the administration says that even the letter of intent can be submitted as late as Dec. 14.

Ms. Sebelius will then have two weeks - until Jan. 1 - to decide which states are capable of running their own exchanges. Starting in October, people can enroll in health plans, for coverage starting Jan. 1, 2014, when most Americans will be required to have health insurance.

Many Republican governors, meeting this week in Las Vegas, complained that they lacked the information needed to decide on creation of exchanges.

However, Gov. Dave Heineman of Nebraska, a Republican, announced Thursday that his state would not establish an exchange.

A state-based exchange would not be controlled by the state because policy decisions would be "totally dictated and totally controlled by the federal government," Mr. Heineman said.

The governor said he was even more concerned about the cost, $646 million from 2013 to 2020.